What happened?
While emptying the substance (during grouting) from the container the temporary site supervisor climbed on the container to guide the tube. He did not respect the work instruction, the LSR (Rule n°6, work at height) was breached and he was not wearing any PPE. Person was immediately asked to stop his activities and was removed from site.
What went wrong?
- Person did not respect instructions, although he was aware of them.
- Person was on top of container without any fall protection.
- Person did not wear any PPE (Personal Protective Equipment).
- Person used a ladder instead of a mobile scaffold as described in the JHA.
- Person short-cut the job (he said he was in a hurry).
- Person did not do his Last Minute Risk Analysis (LMRA).
Lessons learned
- Always follow the instructions agreed for the job.
- Know and respect the Life Saving Rules: Protect yourself against a fall when working at height.
- Never short cut (It’s often an incident root cause).
- Always do your Last Minute Risk Analysis (LMRA).
- Always wear the correct PPE.